Stephanie Jean Gordon, L.AC., MSTOM

Primary specialty

AcupuncturistTaxonomy code 171100000X

License

84000170A Issued in IN

Practice address

410 Wabash St
Michigan City, IN 46360-3334

Phone

(219) 262-2670

NPI assigned

Aug 9, 2013

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1376006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1619309945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 WABASH ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603334",
            "telephone_number": "219-262-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 WABASH ST",
            "city": "MICHIGAN CITY",
            "state": "IN",
            "postal_code": "463603334",
            "telephone_number": "219-262-2670"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3111 N California Ave",
            "address_2": "#3",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606187007",
            "country_code": "US",
            "telephone_number": "630-881-2644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORDON",
        "first_name": "STEPHANIE",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "L.AC., MSTOM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-08-09",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IN",
            "license": "84000170A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Edna M Gonzalez
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• Dennis Gooch Jr.
• Eric James Goodson, R.PH.
• Melissa Ann Gouger, ACNPC-AG
• Great Lakes Medical Equipment Corp
• Tiffany Green, MSW
• Donald Ernest Greer Jr.
• Kristine Griffis, RN

• Acupuncturist in Michigan City, IN
• Providers in Michigan City, IN by specialty
• Acupuncturist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.